Histoplasmosis involving tongue, larynx, lungs and probably liver

T,gL>

QU.\RTERI.TT

RET-IE1V OF MTERIZTURE

. . She has l~ronounc.ed ~,on,jurlc.ti~-iti~ aspe<*t of the upper lip there is au ox-al ttalate arc 4mil:trL~ inrc)l\-ed. Inspection in the the i-ocal or&, \vith ulceration+ there are superficial ulccrntionh.

in the right e:-e, with exudation, On the inner, superficial ulceration. The buccal mucosa and of the lar\-ns re\ rain redness and ulceration of h~pophar~ns nlso. Around the urethral meatus

“Throat cu1ture.i showed 11orma1 flora aud Hemophilus hemulyticus. Smears from lesions in the mouth were negative for diphtheria and Yinrent’s organisms. Cultures from the conjunctiras repeatedly showed no growths. Blood cultures were repeatedly negative. The results ot’ the Frei and Ducretests were negati\-e. No &kle cells were found. ’ * A l,iol)s~ u as p~rf’ormrtl on a lesion of the I~uccal mu,‘083 and revealed chronic: inflammation of the mu~ou* mtmt~ranr, Irith ulceration. ”

acute and T. J. c’.

Histoplasmosis Involving Tongue, Larynx, ,Syph. 62: 933, December, 1950.

Lungs

and Probably

Liver.

Arch.

Dermat.

&

“J. B., a K-j-ear-old white man, acquired an ulcer of the tongue in December, 1948. 1,ater he became hoarse and lost 7 pounds (3 Kg.). When first, seen he presented a deep ulcer (1 by 1.5 cm.) on the anterior right side of the tongue. The liver was felt 8 cm. below the right costal margin. A biopsy of the tongue showed chronic granulomatous inflammation and bodies resembling Histoplasma capsulatum, and a lirer biopsy showed miliary granulomas but no micra organisms. H. capsulatum was isolated in cultures from secretions. No acid-fast bacilli were found on repeated tongue, stools and bronchial Guinea pig inoculation showed reticulum cell hyperplasia of the spleen. examinations. “Treatment consisted of the administration of copper sulfate, li grain (15 mg.) Penicillin, streptomycin, sulthree times daily and in l:S,OOO solution as a mouth wash. fadiazine and iodides given b,- mouth and intravenously were used. The ulcer has shown progressive healing since July, 1919. ” T. J. C.

ORALSURGERY Adamantinomas.

Carman

Weder.

Canad.

&I. A. J. 63: 590, December,

1950.

In spite of its rare occurrence, the adamantinoblastoma has been recognized as a pathologic entity for almost a hundred years. But, as the author points out, its treatment is still inadequate and \-cry often delayed because of the belief in its benign character. To elucidate some of its clinical and pathologic features and also to discuss the problems arising from its therapy, the author undertook the review of the files of the Saskatchewan (-lancer C1inic.s. Frequancy.-In 26,366 cases (years not given’) registered at the Regina and Saskatoon Clinics, 11,713 were malignant (44.53 per cent). Of this amount 8 cases (0.07 per cent) were diagnosed as adamantinoblastomas. AlI of the cases (8r with one exception were tlia.gnosed histologically: Sit-&---It was fouud that 55 per cent of the known cases of adamantinoblastoma occur in the lower jaw. Willis, ho wever! pointed out that many adamantinoblastomas of the upper jaw are wrongly diagnosed as carcinomas of the antrum. This ma- happen more frequently when no biopsy material is taken and the diagnosis is based on x-rap findings alone. The author found the site of adamantinoblastomas equally divided between the upper and the lower jaws. 25 and 68 with an average of 52 years. Age.--Cases are generally found between But the author warns not to rely too strictly on these figures as the tumor with its slowgrowing character may be present for a loug time before the natient b~cnm~s aa-zre cf